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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana MNJ (Malang Neurology Journal) ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Bali Medika Jurnal Journal Research of Social Science, Economics, and Management
Ni Kadek Mulyantari
Bagian SMF Patologi Klinik, Fakultas Kedokteran Universitas Udayana
Biochemistry, Genetics & Molecular Biology Environmental Science Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Performance of Rapid Antibody Test and RT-PCR as Frontline Test for COVID-19 Diagnosis in Pregnancy: an Experience in Indonesia Evert S. Pangkahila; Ryan S. Mulyana; Hariyasa Sanjaya; Mulyantari K; Daniel H. Susanto
Journal Research of Social Science, Economics, and Management Vol. 1 No. 7 (2022): Journal Research of Social Science, Economics, and Management
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2051.354 KB) | DOI: 10.59141/jrssem.v1i7.106

Abstract

Ensuring an accurate diagnosis is critical for limiting the spread of SARS-CoV-2 and for the clinical management of COVID-19, especially in pregnant women. For now real-time reverse transcription polymerase chain reaction (RT-qPCR) is the currently recommended laboratory method for the diagnosis of acute SARS-CoV-2 infection. More recently, several easy-to-perform rapid antigen detection tests have been developed and are recommended as first-line screening test in several countries. The purpose of this study was to evaluate the comparative performance of a rapid antibody test and RT-PCR for the detection of SARS-CoV-2 infection, as a front-line test for the diagnosis of COVID-19 in pregnancy. This research method is a descriptive study to describe comparation of sensitivity and specificity between rapid SARS-CoV-2 antibody test to the gold standard nasopharyngeal RT-PCR swab test. Of the 271 samples, only 257 were eligible and fourteen cases were excluded from the study due to a lack of rapid antibody test and RT-PCR results. The results of this study showed that the rapid SARS-CoV-2 antibody test sensitivity was 80.95%, and the specificity was 90.68%, the NPV (negative predictive value) and the PPV (positive prognosis value) were 98.17% and 43.59%, respectively. Based only on the results of IgM and IgG, IgM and IgG sensitivity were 33.33% (7/21) and 71.43% (15/21), respectively, and the specificity was 91.1% (215/236, 21 false positive) and 91.53% (216/236, 20 false positive), respectively. The use of rapid antibody tests during pregnancy is a screening tool and is not currently applicable for diagnostic tool. To minimize false positives and negatives results, the use of rapid antibody tests should be combined with the RT-PCR test results.
AUDIT SYSTEM FOR USAGE OF BLOOD PRODUCT IN SANGLAH GENERAL HOSPITAL DENPASAR BALI Kadek Mulyantari; Teguh Triyono; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1382

Abstract

Blood transfusion is one of very important therapy components. One indicator of the blood services quality in Sanglah  General Hospital Denpasar Bali Indonesia is achieving the target of unused blood order ≤ 10% per month. However, these targets have not been achieved. The number of unused blood orders reached 6,719 bags per year (600 bags per month or 21.5%). Unused blood orders is mostly from Department of Internal Medicine (40.9%), followed by Department of Surgical (35.6%),  Department of Obstetrics and Gynecology (15.5%) , and Department of Pediatrics (8%). The high number of unused blood orders can causes several problems such as the disorder of blood supply, inefficiency of pre-transfusion testing and decreased quality of blood product. Considering the consequences of high unused blood order, it is necessary to conduct a research on audit system for usage of blood product in Sanglah Hospital.The aim of study are to analyze the influence of audit system to reduce unused blood order and to decrease the number of C/T ratio. The study design was a pre and post test intervention study. The population in this study were all forming of blood requests in Sanglah Hospital. The sample is blood request form Department of Internal Medicine of the last two months. Intervention in this study was the development and dissemination of guidelines for usage of blood products, followed by concurrent audit and prospective audit of the sample.The study show there are decline of unused blood orders and C/T ratio before and after implementation of the audit system for usage of blood products. Reduction of unused blood order in Sanglah Hospital is 5.4%, and in the Department of Internal Medicine is 5.2%. The causes of unused blood orders were patient died, overestimation of blood order, transfusion delays because waiting for the schedule of hemodialysis, the patient has a fever, blood product has expired, and the occurrence of administration errors. Reduction of C/T ratio in Sanglah Hospital is 0,094 and in the Department of Internal Medicine is 0,072. Audit system for usage of blood products can reduce unused blood orders and decrease C/T ratio.
A child with Down Syndrome and Type 2 Diabetic Mellitus Betti Bettavia Hartama Pardosi; Sianny Herawati; Ni Kadek Mulyantari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1831

Abstract

Down Syndrome (DS) is one of the common chromosomal disorders that raise mental retardation. It is known that DS patients have an autoimmune disorder affecting the endocrine and non-endocrine organs. It is a rare occurrence of type 2 Diabetes Mellitus (type 2 DM) disease in children with DS. Type 2 DM occurs due to impaired insulin secretion and excessive hepatic glucose production, unlike type 1 DM, caused by the destruction of íŸ-cells in autoimmune Langerhans. A 10-year-old girl patient was referred from Tabanan Hospital to Sanglah Hospital, Denpasar. Patients were admitted to the hospital with decreased consciousness, treated for four days, and observed in ICU for 2 days. Vomiting twice, no seizures, urinating normally. No significant past medical history was found. Physical examinations showed a typical Mongolian face, short neck, expanded occipital area, small eyes, and a mouth with a prominent tongue. Laboratory data revealed fasting blood glucose of 473 mg/dL and an HbA1C level of 12.6%. Urinalysis showed ketone 3+. The C-peptide test showed a reasonably good íŸ pancreas cell function. Down syndrome is associated with autoimmune diseases, including type 1 diabetes. The exact number of down syndrome cases with type 2 DM remains unknown; however, it was known that the case is infrequent.
Perbedaan Hasil Tes Fungsi Ginjal Menggunakan Klirens Kreatinin dan Estimasi Laju Filtrasi Glomerulus (e-LFG) CKD-EPI Mahardika, Ketut Indah Karina; Herawati, Sianny; Mulyantari, Ni Kadek; Subawa, Anak Agung Ngurah
E-Jurnal Medika Udayana Vol 12 No 1 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i01.P15

Abstract

Background. Chronic diseases have become one of the world's public health problems in recent decades, and mortality rate are projected to continue to rise. The diagnosis and severity of CKD is based on the results of renal function tests recommended by KDIGO is Glomerulus Filtration Rate (GFR) patients. A simple and inexpensive method is to use endogenous filtration markers to calculate GFR such Creatinine Clearance Test (CCT) or e-GFR CKD EPI formula. Accurate calculation of GFR by CCT and e-LFG CKD-EPI are important to avoid misdiagnosis of CKD. This study aimed to determine if there is any difference in the results between these two methods. Method. This study used analytical observational cross-sectional research method. Samples were selected from the population based on inclusion criteria having complete variability data and no exclusion criteria. Analyzed by SPSS software version 28 to check normality using Kolgomorov-Smirnov test, significance test with Mann Whitney and Spearman to check correlation. Results. The results of the study of 1257 samples, showing that the data are not normally distributed (p = 0.000), had a significant difference between CCT and e-GFR CKD EPI (p = 0.000) and the correlation is linear and moderate correlation strength (r=0.403) (p=0.000). Conclusion. Differences in kidney function test results using CCT and e-GFR CKD-EPI methods in patients who carried out laboratory examinations at the clinical pathology laboratory at Sanglah Hospital, Bali during April 2020–April 2021, was found that there were differences in the results of CCT and e-GFR CKD EPI.
Karakteristik Pasien Dengan Gigitan Ular Di RSUP Sanglah Bali Periode 2019-2020 pradnya wibawa, komang budhi; Mulyantari, Ni Kadek; Yasa, I Wayan Putu Sutirta
E-Jurnal Medika Udayana Vol 11 No 8 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i8.P12

Abstract

ABSTRAK Latar Belakang : Sebagai negara tropis, Indonesia memiliki risiko gigitan ular yang cukup tinggi. Bisa ular yang mengandung berbagai macam enzim polipeptida serta protein yang bersifat hematotoksik dapat menyebabkan berbagai gejala mulai dari bengkak, kelumpuhan hingga kematian. Pemberian Anti Bisa Ular (ABU) memegang peranan penting dalam menurunkan angka mortalitas dari gigittan ular. Penting untuk mengetahui karakteristik dari kasus gigitan ular agar penanganan sesuai dapat segera diberikan. Tujuan : Studi ini bertujuan untuk mengetahui gambaran pasien yang menjadi korban gigitan ular di RSUP Sanglah. Metode Studi ini merupakan studi deskriptif dengan pendekatan cross-sectional dimana data hanya diambil pada satu waktu tertentu. Sampel yang dimasukkan dalam studi ini berupa pasien gigitan ular yang terdaftar di RSUP Sanglah selama periode penelitian. Pasien dengan data rekam medis yang tidak lengkap diekslusi dari studi ini. Hasil : Didaapatkan sebanyak total 50 pasien yang memenuhi kriteria inklusi penelitian.Usia beragam dari 5 tahun hingga 77 tahun dengan rerata 38.06 + 17.0 tahun. Sebagian besar pasien merupakan mahasiswa (32%) disusul oleh petani (26%) dan IRT (14%). Jenis kelamin yang mendominasi adalah lelaki dengan persentase 64%. Seluruh pasien mendapatkan tatalaksana berupa anti bisa ular, dan tidak ada yang memiliki komorbiditas. Sebanyak 74% kasus mendapatkan lokasi gigitan pada kaki. Kesimpulan : Dapat disimpulkan bahwa karakteristik pasien gigitan ular di RSUP Sanglah merupakan pasien dewasa, laki-laki, berprofesi sebagai mahasiswa, dan digigit pada bagian kaki. Seluruh pasien mendapatkan terapi ABU. Kata Kunci : Venom, Gigitan , Ular
KARAKTERISTIK FERITIN SERUM PADA PASIEN PENYAKIT GINJAL KRONIK YANG MENJALANI HEMODIALISIS DI RSUP PROF. DR. I.G.N.G. NGOERAH Wikananda, Made Argyanta; Herawati, Sianny; Mulyantari, Ni Kadek; Subawa, Anak Agung Ngurah
E-Jurnal Medika Udayana Vol 13 No 5 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i05.P04

Abstract

Penyakit ginjal kronik (PGK) sebagai permasalahan kesehatan global dengan resiko terjadinya kematian. Abnormalitas pada struktur ginjal menyebabkan adanya penurunan fungsi ginjal dengan kerusakan pada histologi dan penurunan laju filtrasi glomerulus. Faktor yang mempengaruhi terjadinya PGK antara lain usia tua, diabetes, hipertensi, obesitas, penyakit kardiovaskular dan pola hidup tidak sehat. Perkembangan medis telah mengembangkan pergantian fungsi ginjal dengan menggunakan alat berfungsi sebagai ginjal buatan yang dinamakan hemodialisis. Pemeriksaan feritin serum dan saturasi transferin menjadi parameter laboratorium paling umum. Rancangan penelitian deskriptif observasional dengan menggunakan metode potong lintang. Sampel total dipilih sebagai metode pengambilan sampel. Subjek PGK pada penelitian ini berjumlah 143 orang dengan feritin serum tinggi yaitu 113 orang (79%) distribusi pasien terbanyak ditemukan pada jenis kelamin perempuan yaitu 58 orang (40.6%), Pada kelompok usia dengan feritin serum tinggi terbanyak pada kelompok lansia awal (46-55 tahun) berjumlah 31 orang (21,7%). Berdasarkan lama menjalani hemodialisis terbanyak menjalani hemodialisis >5 tahun yaitu 57 orang (39,9%), Riwayat penyakit terdahulu didapatkan banyak mengalami hipertensi yaitu 29 orang (20,3%). Seluruh pasien mengalami derajat PGK yang sama yaitu stadium 5. Pasien PGK yang menjalani hemodialisis dominan mengalami feritin serum tinggi. Ditemukan pada jenis kelamin perempuan, kelompok usia lansia dewasa dengan lama menjalani hemodialisis >5 tahun dan memiliki riwayat penyakit terdahulu yakni hipertensi. Kata kunci : feritin serum, PGK, Hemodialisis
Karakteristik Hasil Pemeriksaan Hematologi dan Kecepatan Pemulihan Pasien DBD di RSUD Bali Mandara Tahun 2019-2020 Nugraha, Ketut Yoga Wira; Subawa, Anak Agung Ngurah; Herawati, Sianny; Mulyantari, Ni Kadek
E-Jurnal Medika Udayana Vol 11 No 10 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i10.P05

Abstract

ABSTRACT Dengue Hemorrhagic Fever (DHF) as one of the most common infectious diseases in the world is still a major concern even though the incidence and mortality rates have decreased. The study objective is to determine hematological examination results and the speed of recovery of DHF patients reviewed according to age, gender, BMI, degree of DHF, and duration of fever before being treated. This was cross-sectional study using secondary data from medical records of 193 DHF patients treated from year 2019 to 2020. In 193 patients, before being admitted to the hospital, the patient had an average fever for 4.12±1.16 days with an average 4.69±1.2 days of hospitalization. Hematological test on hospital admission showed the average platelet value was 83.06±28.74 x103 cells/µL with 187 (96.9%) patients had platelet values below the normal value. Average leukocyte count was 4.13±2.01 x 103 cells/µL with 126 (65.3%) patients having a leukocyte value below the normal value. Average hematocrit value was 40.31±4.96% with 113 (58.6%) patients had normal hematocrit values. The duration of hospitalization for DHF patients had a significant difference when viewed according to age (p=0.000), BMI (p=0.000), and duration of fever before being treated (p=0.000). The mean platelet values were significantly different when compared according to the duration of fever before being treated (p=0.018). The mean leukocyte values were significantly different when compared according to age (p=0.007) and gender (p=0.008). The mean hematocrit value was significantly different when compared according to age (p=0.000) and gender (p=0.008). Keywords: Dengue hemorrhagic fever, hematological examination, duration of hospitalization
HUBUNGAN MELEWATKAN SARAPAN TERHADAP KEJADIAN OVERWEIGHT DAN OBESITAS PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS UDAYANA Swari, Kadek Gyna Yadnya; Mulyantari, Ni Kadek; Yasa, I Wayan Putu Sutirta
E-Jurnal Medika Udayana Vol 11 No 3 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i03.P18

Abstract

ABSTRAK Overweight dan obesitas merupakan salah satu masalah kesehatan yang menjadi sorotan dunia bahkan di Indonesia sekalipun. Prevalensi overweight dan obesitas dari tahun ketahun mengalami peningkatan yang cukup signifikan setiap tahunnya. Mahasiswa kedokteran termasuk ke dalam golongan dewasa muda. Mahasiswa kedokteran memiliki komitmen akademik dan non akademik yang dapat berpengaruh terhadap perubahan pola makan, khususnya melewatkan sarapan. Tujuan penelitian ini adalah mengetahui hubungan melewatkan sarapan terhadap kejadian overweight dan obesitas pada mahasiswa fakultas kedokteran universitas udayana. Penelitian ini dilakukan dengan menggunakan metode observasional analitik dengan pendekatan cross sectional. Jumlas sampel pada penelitian ini berjumlah 42 mahasiswa/i dengan Teknik pengambilan sampel yaitu purposive sampling. Melewatkan sarapan diukur menggunakan kuesioner sedangkan indeks massa tubuh diukur dengan menggunakan alat pengukur timbangan badan dan tinggi badan. Hasil analisis statistik dengan menggunakan uji chi-square didapatkan nilai signifikan 0,004 < 0,05. Ini berarti terdapat hubungan melewatkan sarapan terhadap kejadian overweight dan obesitas pada Mahasiswa Fakultas Kedokteran Universitas Udayana. Hasil penelitian ini diharapkan mahasiswa lebih memperhatikan sarapan pagi dan penelitian selanjutnya diharakan dapat memasukkan kategori food recall 24 hours. Kata Kunci: Sarapan, Overweight, Obesitas
EVALUATION OF VITAMIN B12 LEVELS WITH NEUROPATHIC PAIN IN HEMODIALYSIS PATIENTS: A SINGLE CENTER OBSERVATIONAL STUDY Sri Wijayanti, Ida Ayu; Tresna Erawan, I Gusti Ngurah Agung; Mulyantari, Ni Kadek; Tertia, Clarissa; Widyadharma, I Putu Eka
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.03

Abstract

Background: Uremic syndrome in chronic kidney disease (CKD), particularly in hemodialysis (HD) patients, is a growing global health problem. The majority of patients with this condition experience one or more neurological disorders, such as neuropathic pain. One of the adjuvant therapies in the treatment of neuropathic pain is vitamin B12, which is important for the regeneration and myelination of peripheral nerves and also plays an important role in the restoration of functional nerves. Objective: The aim of this research is to evaluate the role of vitamin B12 in the relief of pain symptoms Method: This research was conducted at General Hospital in Bali use a case-control design and consecutive sampling. This was carried use 21 patients with CKD on regular hemodialysis with neuropathic pain, while 22 patients without neuropathic pain were used as the control group. All patients were tested for serum vitamin B12 levels. Neuropathic pain was assessed using the DN4. Results: The data values of total vitamin B12 levels in blood serum were obtained within a range of 81.72 pmol/L to 2337.5 pmol/L, and a median value of 1306.25 pmol/L. A cut-off value of 1509.375 pmol/L was obtained with 76.2% sensitivity and 59.1% specificity. Furthermore, an odd ratio between low serum vitamin B12 and the incidence of neuropathic pain was also obtained, namely OR= 3.611 (95% CI= 1.012-12.9; p=0.044). Conclusion: It was found that low serum vitamin B12 in CKD patients on hemodialysis increased the risk of experiencing neuropathic pain by 3.611 times compared to those with normal serum vitamin B12.
A-9-Years-Old Female with Diabetes Mellitus Type 1 with Hyperthyroidism Puspa Sari, Ni Ketut; Mulyantari, Ni Kadek; Herawati, Sianny; Lestari, AA. Wiradewi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2060

Abstract

Diabetes Mellitus Type 1 (DMT1) and thyroid disease can occur together, which is defined as a variant of autoimmune polyglandular syndrome type 3. It is known that the action of insulin and thyroid hormones affect cellular metabolism, thyroid hormones contribute to carbohydrate metabolism and pancreatic function. Since the thyroid gland plays a central role in the regulation of metabolism, abnormal thyroid function can have a major impact on the control of diabetes and poor glycemic control can cause alterations in thyroid hormone. A female, 9 years old, with decreased consciousness. Previous medical history, polyuria, increased appetite, and drastic weight loss. She also complained of sweating even in a cold room and was often emotional. On physical examination, there was fever, shortness of breath, tachycardia, and a soft and diffused slightly enlarged thyroid gland, with no bruit on auscultation. Laboratory tests showed blood glucose levels at 739 mg/dL, HbA1c 9.2%, C-peptide 0.2 ng/mL, TSH levels 0.01 µIU/mL, FT4 levels 2.77 ng/dL, the presence of metabolic acidosis, proteinuria, glucosuria, and ketonuria. Thyroid dysfunction will have a negative effect on DM control while poor glucose control will harm the work of thyroid hormones. Improvement in glycemic control and routine insulin injection with the right dose will reduce the risk of diabetic vascular and metabolic complications onset and progression.
Co-Authors Anak Agung Ayu Lydia Prawita Anak Agung Ayu Lydia Prawita Anak Agung Ngurah Subawa Anak Agung Wiradewi Lestari aryati . Bagus Dwiki Arya Dharma Betti Bettavia Hartama Pardosi Daniel H. Susanto Desak Laksmi Dewi, Ni Made Ratih Purnama Ekarini Katharina Yunarti Nabu Ekarini Katharina Yunarti Nabu Ekarini Katharina Yunarti Nabu Endang Retnowati Evert Solomon Pangkahila Fatqur Rochman Gde Dicky Arimbawa I Gede Juliarta I Gusti Agung Ngurah Radhitya Wijaya Radhitya Wijaya I Made Kardana I Nyoman Hariyasa Sanjaya I Nyoman Wande I Nyoman Wande I Putu Eka Widyadharma I Putu Yuda Prabawa I Wayan Putu Sutirta Yasa Lestari, AA. Wiradewi Luh Putu Citta Saraswati M.Y. Probohoesodo Made Minarti Witarini Dewi Mahardika, Ketut Indah Karina Nasronudin Nasronudin Ni Ketut Puspa Sari Ni Komang Krisnawati Ni Komang Krisnawati Ni Made Linda Pertiwi Ni Nyoman Mahartini Ni Nyoman Mahartini Nugraha, Ketut Yoga Wira Nyoman Pramudita Parwati, Putu Ayu Prabangkara, Ni Made Indira Prabawa, I Putu Yuda pradnya wibawa, komang budhi Puspa Sari, Ni Ketut Putu Mita Wulandari Ryan S. Mulyana Ryan Saktika Mulyana Sianny Herawati Sianny Herawati Sri Wijayanti, Ida Ayu Sudana, I Nyoman Gde Sudewa Djelantik Swari, Kadek Gyna Yadnya Teguh Triyono Tertia, Clarissa Tjokorda Gede Oka Tresna Erawan, I Gusti Ngurah Agung Usi Sukorini Wikananda, Made Argyanta Wira Gotera Zulaikha Binti Osman